![]() There is no current treatment for Argyll Robertson pupil, but its progression can be slowed by treating the underlying cause.įor patients with syphilis, penicillin or doxycycline are often prescribed. ![]() A slit-lamp exam can help an eye doctor distinguish between Argyll Robertson pupil and Adie’s tonic pupil. AR pupils are quick to focus on nearby objects, while Adie’s tonic pupils are slow to focus overall.ĭamage to or inflammation of a bundle of nerves in the eye socket is the most common cause of Adie’s tonic pupil. The other major difference between the two disorders is the response to nearby objects. However, while AR pupils are small and misshapen, Adie’s tonic pupils remain dilated, regardless of light levels. Adie’s tonic pupil is also characterized by light–near dissociation. How is Argyll Robertson pupil different from Adie’s tonic pupil?Īrgyll Robertson pupil is sometimes confused with tonic or Adie’s tonic pupil. A magnetic resonance imaging (MRI) of the brain is the most common test for multiple sclerosis. A blood test called Hemoglobin A1c can be used to check for diabetes. If syphilis is ruled out, the next step may be to look for signs of diabetes mellitus or multiple sclerosis. To perform this test, the physician will insert a long needle into the patient’s lower back to extract a sample of CSF. Pupil irregularities can also show up with tabes dorsalis, about half of which are AR pupil.įor an official syphilis diagnosis, the physician may do a spinal tap to test for antibodies in the cerebral spinal fluid (CSF). Tabes dorsalis, a form of neurosyphilis, is often present at this stage. The specialist will look for indications of tertiary syphilis. If they suspect AR pupil, the eye doctor may refer the patient to an infectious disease specialist. This exam involves the use of a microscope with a bright light that allows the physician to see inside the eye. They may also perform a slit-lamp exam to check for a weakened iris. If the pupil is still able to constrict quickly to focus on nearby objects, the eye doctor will then look for small, misshapen pupils. The first sign of Argyll Robertson pupil is slow constriction in bright light. They shrink (constrict) in bright light or when focusing on a nearby object. Healthy pupils expand (dilate) in dim light or when focusing on a distant object. READ MORE: How multiple sclerosis impacts eyes and vision How is Argyll Robertson pupil diagnosed? If the lesions form in the area of the brain that controls the eye’s response to light, they can cause AR pupil. The attacks target myelin, the protective layer surrounding nerve endings, creating lesions.īecause MS can attack any part of the nervous system, symptoms will vary from person to person. Multiple sclerosis (MS) is a disease that causes the body’s immune system to attack its central nervous system. READ MORE: How diabetes can impact the eyes Multiple sclerosis AR pupil can develop when long periods of high blood sugar levels cause nerve damage that triggers lesions. Glucose is a sugar and the body’s main source of energy. READ MORE: Ocular syphilis: Symptoms and treatment when syphilis spreads to the eyes Diabetes mellitusĭiabetes mellitus is a condition in which the body does not effectively regulate glucose levels in the bloodstream. During this stage, syphilis is not contagious.Ĭases of Argyll Robertson pupil that are not related to syphilis are also called pseudo-Argyll Robertson pupil. Only one-third of individuals with syphilis will develop tertiary syphilis. The final stage, also called tertiary syphilis, can lead to the development of Argyll Robertson pupil. When left untreated, syphilis can progress through three stages. It is most commonly transferred through sexual intercourse. Syphilis is a bacterial infection that causes lesions throughout the body. The most common cause of AR pupil is late-stage syphilis. Other potential causes are chronic alcoholism, shingles, Lyme disease, encephalitis and neurosarcoidosis. There are several diseases that can cause Argyll Robertson pupil, the most common of which are discussed below. The lesion can also lead to an atrophied or weakened iris. Eventually, the pupils may completely lose their ability to respond to light. This leads to a slow loss of light response that is not always equal in both pupils. The lesion develops over time and sometimes unevenly. The lesion does not affect the fibers responsible for focusing on nearby objects. The lesion that causes AR pupil forms on the area of the nucleus that handles light reaction. The midbrain helps to govern the movement of the eyes. ![]() The Edinger-Westphal nucleus is located in the section of the brain that connects the spinal cord and the brain, called the midbrain. ![]() Argyll Robertson pupil develops when a lesion - a damaged area of tissue - forms on the Edinger-Westphal nucleus.
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